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When should patients talk to their doctor about pain? continued...

Whenever pain lasts longer than reasonably expected, it's crucial to treat it to keep it from worsening into chronic pain, he says. For example, a small cut or burn normally wouldn't cause pain after a month; if it does, call your doctor rather than waiting for three months.    

People with disorders that cause chronic pain should also talk to their doctors about treatments that provide relief or help them to cope with pain. Treatments include pain relievers and other medications, acupuncture, biofeedback, relaxation training, hypnosis, distraction techniques, and transcutaneous electrical nerve stimulation. With this last method, patients use a TENS device to pass a mild electrical current through the skin to reduce pain.  

When should a patient seek a referral to a pain specialist?

"Most pain is not handled by pain specialists, it's handled by primary care physicians," Fraifeld says. That's the proper starting point, he says; many primary care doctors are able to treat pain successfully. However, if your primary care doctor is unable to diagnose the cause of your pain, is unfamiliar with your type of pain, or is unsure of how to treat it, ask for a referral to another doctor who has experience with your particular symptoms or disease.

Most patients with pain don't need to see a pain specialist. But if pain lasts much longer than expected, or your primary care doctor or specialist hasn't been able to treat your chronic pain satisfactorily, ask whether a referral to a pain specialist would help, Fraifeld says.

"[Patients] should go to a physician specifically trained in pain," he adds. That way, they'll receive a medical exam to diagnose their problem, as well as proper pain management. Typically, these pain specialists come from the fields of neurology, anesthesia, psychiatry, and physical medicine and rehabilitation, according to Fraifeld. Then they undergo additional training in pain medicine.

What to avoid? Pain clinics, often run by non-physicians, that offer injections or other treatments without first doing a thorough exam to make a medical diagnosis. "Unfortunately, the propensity for this is increasing around the country," Fraifeld says.   

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